Reassurance

[stewie]

Hi back in the NHS again next week and due to have a booster Hep B jab tomorrow my original was back in 2005 when starting my nurse training

I know the Hep b is not a live vaccine and cannot see any issues arising from the booster just wanted to put it out there to the more informed members just incase I'm missing something , my consultant off at the moment and my GP does not have a great understanding of CLL and it usually takes a few days now to get a telephone call back and the nurse doing the vaccines will probably have less idea then myself when it comes to our condition

Many thanks

Stewie

[cajunjeff]

Stewie, I am no expert. I personally think any decision about any vaccine we do should be in consultation with our cll expert. I can venture a guess what your expert might say.

Generally speaking, we are encouraged to take non live vaccines like for the flu, pneumonia, shingles and covid. As a group, we will likely have suboptimal responses to all vaccines, particularly if the vaccine effectiveness is measured by antibody response. Antibodies are made by bcells. Cll is a disease of the bcells, so we are not great at making antibodies.

In general, the longer we have cll, the less good we are at making antibodies. Treatments with drugs like ibrutinib and certain monoclonal antibodies further deplete our antibody making bcells. We are seeing with the covid vaccines that cll patients taking some treatments are almost certain to not produce covid antibodies from the vaccine. Its reasonable to conclude those of us in treatment for cll will be more likely than others with cll to have subpar responses to vaccines.

As a general rule again, we are still encourage to take non live vaccines because the vaccines might help and the risk of harm from non live vaccines is very low.

The thinking is that any help is better than no help. I took the covid vaccine and tested negative for antibodies. But any protection is better than none. My body has now seen a covid antigen in the vaccine and even without a lot of functional antibodies, other parts of my immune system might recognize the virus if I get it and help me.

My guess is your cll doctor will say go for the hepB vaccine as any help is better than none.

The overall message from these studies is that CLL patients can respond to vaccines. Although the response rate (particularly to the hepatitis B vaccination) was lower than what we had hoped for, some immunity is better than no immunity.

cllsociety.org/2021/03/ash-...

[stewie in reply to cajunjeff]

Thanks for taking the time to reply Jeff , you were spot on , one of understudy team phoned said absolutely get it done , looked at one of studies done Hep b , people on the BTK ranged from 6% to 27 % response to the vaccine....I would imagine the average was a lot closer to 6 % than the 27 % Thanks again Jeff

Stewie